Final Rinse Optimization: Influence of Different Agitation Protocols

IntroductionThis study examined the effect of different root canal irrigant agitation protocols in the penetration of an endodontic irrigant into dentinal tubules.MethodsFifty-six human single-rooted teeth were shaped with nickel-titanium instruments, and a final rinse of 5% sodium hypochlorite labeled with 0.2% alizarin red was performed. Specimens were assigned to 7 groups (N = 8) and submitted to the following rinse activation protocols: no agitation (control group), K-File or gutta-percha agitation, or different sonic (EndoActivator [Advanced Endodontics, Santa Barbara, CA] and Plastic Endo, Lincolnshire, IL) and ultrasonic (Satelec [Acteongroup, Merignac, France] and EMS, Nyon, Switzerland) agitations. Specimens were sectioned at 1, 3, and 5 mm from the apex in 1-mm-thick slabs, ground, and prepared for fluorescence microscopy at 100× with a wavelength of 450 milliseconds. Irrigant penetration into dentinal tubules was analyzed by using Kruskal-Wallis analysis of variance followed by post-hoc comparisons.ResultsGroups were ranked in the following order: control = K-file = gutta-percha < EndoActivator = Plastic Endo < Satelec = EMS. At 1 mm from the apex, the highest score was found for the EMS group compared with the control, K-file, gutta-percha, EndoActivator, and Plastic Endo groups, whereas no difference was found with the Satelec group.ConclusionThe results support the use of an ultrasonic agitation to increase the effectiveness of the final rinse procedure in the apical third of the canal walls.